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Yousaf Khan Lecturer Renal Dialysis Technology • A Pancreas is a soft, lobulated organ that stretches obliquely across the posterior abdominal wall in the epigastric region. • It is situated behind the stomach and extends from the duodenum to the spleen. • The Pancreas in addition to its digestive function, secretes two important hormones 1. Insulin 2. glucagon • The Pancreas is composed of two major types of tissue. • The Acini: Which secrete digestive juices. • The Islets of Langerhans: which secrete insulin and glucagon. • The Islets contain Three types of cell a. Alpha cells: Secrete glucagon b. Beta cells: Secrete insulin c. Delta cells: Secrete somatostain • Is secreted from the pancreas by the beta cells of Islets of Langerhans. Chemistry: Insulin is a small soluble protein containing 51 amino acids. • Half-life of insulin is 15-30 minutes. Transport: Circulate in the blood combined to beta globulin. • Insulin, being a protein is destroyed by proteolytic enzymes of GIT. • So it is not given orally, but by subcutaneous injection or in serious condition administered intravenously. • Insulin is inactivated by enzymes, especially by an enzyme of liver called glutathione insulin transhydrogenase. • Carbohydrate Metabolism: a. It increase glucose entry into the cells by stimulation process of facilitated diffusion. Specially in muscles, adipose tissues, heart etc b. It increases the utilization of glucose for energy. c. It increase glycogen storage in cells. d. It increases the conversion of glucose into fat to be stored in adipose tissues. e. So it is the only Hypoglycemic Agent of body. • It increase fat deposition • Increase fat formation from glucose • Insulin deficiency leads toward hyperlpidemia, free fatty acidemia and finally, ketosis and ketonuria. • Increase active transport of amino acids into the cells even against the concentration gradient. • It increase protein synthesis, so overall it increase muscle mass. • Increasing factors: 1. Hyperglycemia 2. Fructose 3. Amino acid 4. Ketones 5. Glucagon 6. G.H 7. Cortisol 8. Thyroxin 9. Pregnancy and lactation • Decreasing factors: a. Hypoglycemia b. Starvation c. Exercise d. Stress • It s secreted from the pancreas by the alpha cell of islet of Langerhans. • Chemistry: it is polypeptide containing 29 amino acid. Carbohydrate Metabolism: • Hyperglycemic hormone a. It increase glycogenolysis (Break down of glycogen to glucose) in liver b. It increase gluconeogenesis (the generation of glucose from non-carbohydrate carbon substrates like pyruvate, lactate,glycerol, glucogenic amino acids, and fatty acids) especially in the liver cell. • Promotes proteolysis (the breakdown of proteins or peptides into amino acids by the action of enzymes) • Increase amino acid entry in hepatic cells • Promotes gluconeogenesis from amino acid • raised blood urea level. • Leads towards hyperlipidemia • Mobilization of fats from adipose tissue • Increase lipolysis, promotes gluconeogenesis • • • • • • INCREASING FACTORS Hypoglycemia Exercise Starvation Malnutrition Stress Excess of insulin • • • • • DECREASING FACTORS Hyperglycemia Hyperlipidemia Ketonemia SomatostaIn Lack of insulin NOTE: Glucagon and Adrenaline have opposite action of insulin therefor are known as Insulin Antagonists • Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. The Types of Diabetes • There are two Types of diabetes….. • One is Type 1 Diabetes • The other is Type 2 Diabetes • Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels. What Causes Type 1 Diabetes • The body's own immune system attacks and destroys beta cells in the pancreas that are responsible for creating the hormone insulin. • Type 2 diabetes formerly called non-insulindependent diabetes is a disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. What Causes Type 2 Diabetes • Type 2 diabetes occurs when the pancreas doesn't make enough insulin or the cells of the body become resistant to insulin. • Hypoglycemia, also called low blood glucose or low blood sugar, occurs when blood glucose drops below normal levels. • Hyperglycemia, or high blood sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. • If you sugar is 70 or lower you should treat it with…. ½ a glass of juice ¼ glass of soft drink 2 or more glucose tablets if necessary • If your sugar is above 240 you should do the followings: Drink lots of sugar-free fluids like water or diet drinks Eat the right food and the right amounts Check your blood sugars more often Check ketones if over 240 Call doctor or nurse if you have a positive ketones • Be physical active…. • Eat a healthy diet • Abcs(know and control) Hba1c, blood pressure, cholesterol, and smoking • Take your medication THANK YOU